title: Human parechovirus central nervous system infections in southern California children.
abstract: BACKGROUND
  Human parechoviruses (hPeV) are increasingly recognized as significant etiological agents for meningoencephalitis especially in young children, but testing of cerebrospinal fluid (CSF) for hPeV by PCR is not routinely performed.
  
  
  METHODS
  We used real-time reverse transcriptase PCR for detection of serotypes 1-6 in CSF samples of 440 children who underwent a lumbar puncture to exclude an infectious etiology of their clinical presentation. We then compared the prevalence and clinical presentation of children with hPeV-positive CSF with that of children with enterovirus (EV)-positive CSF.
  
  
  RESULTS
  HPeV was detected in 2.7% and EV in 10.7% of CSF samples. Many hPeV-positive patients were <3 months of age and usually had CSF parameters within the age-adjusted normal range. However, children with hPeV-positive CSF presented with neurologic symptoms more frequently than those with EV-positive CSF.
  
  
  CONCLUSIONS
  HPeV infections of the central nervous system occurred mainly in young infants and were more commonly associated with neurologic symptoms at presentation, despite the fact that CSF findings were within the normal range in the vast majority of these cases. HPeV should be included in the differential diagnosis of young children with central nervous system symptoms and sepsis-like illness, even in the presence of normal CSF parameters.
authors.affiliation: From the *Division of Pediatric Infectious Diseases; †Molecular Microbiology Laboratory Services; and ‡Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA.
authors.forename: Susanna
authors.initials: S
authors.lastname: Felsenstein
authors.forename: Shangxin
authors.initials: S
authors.lastname: Yang
authors.forename: Natalie
authors.initials: N
authors.lastname: Eubanks
authors.forename: Edwin
authors.initials: E
authors.lastname: Sobrera
authors.forename: John P
authors.initials: JP
authors.lastname: Grimm
authors.forename: Grace
authors.initials: G
authors.lastname: Aldrovandi
mesh_terms: D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D004770:Enterovirus; D004769:Enterovirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008587:Meningitis, Viral / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D030061:Parechovirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D010850:Picornaviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D013129:Spinal Puncture